Request for Atlantic Surfclam or Ocean Quahog ITQ Alloca

Request for Atlantic Surfclam or Ocean Quahog ITQ Allocation or Cage Tag Transfer

Section 1. Check which type of transfer you are requesting:

	Permanent ITQ Allocation Transfer
	Temporary Cage Tag Transfer

Section 2.

Transferer (Seller)
Name:		Allocation Number:
Cage Tags to be Transferred
	Beginning Tag Number	Ending Tag Number	Total Tags
Tag Series 1:
Tag Series 2:
Tag Series 3:

Section 3.

Transferee (Buyer)
Name:	*Allocation Number:
List of allocation numbers in which an interest is owned:	* If an allocation number has not been issued Section 4 of this form must be completed. NMFS will issue an allocation number upon receipt of the completed application.

Section 4.

Name:
Vessel (if applicable):
Street:
City/ State/ Zip:
Telephone:
	U.S. citizen requirement. By checking this box you are indicating that you are eligible to own a documented vessel under the terms of 46 U.S.C. 12102(a) and are able to provide documentation attesting to such eligibility if requested by NMFS.

Section 5.

Printed Name of Transferer or Authorized Agent:	Printed Name of Transferee or Authorized Agent:
Signature of Transferer or Authorized Agent:	Signature of Transferee or Authorized Agent:
Date:	Date:

Public reporting burden for this collection of information is estimated to average 5 minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining data needed, and completing and reviewing the information. Send comments regarding this burden estimate to: NMFS, 55 Great Republic Drive, Gloucester, MA 01930. Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subjected to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control Number.

OMB Control No. 0648-0240 Expiration Date: xx/xx/xxxx